Abstract
IntroductionSubclavian vein thrombosis is a rare but potentially fatal condition that most often occurs iatrogenically or in the context of malignancy. Here we report the case of an active, healthy 32-year-old woman who presented with subtle findings of arm pain, paresthesias and skin changes of acute onset and was subsequently diagnosed with upper extremity deep vein thrombosis and subclavian stenosis, and was started on a course of oral antithrombotics.Case presentationA 32-year-old right-handed Caucasian woman presented to her family medicine clinic with left shoulder pain and numbness along her ipsilateral forearm and hand, as well as subtle swelling of the affected limb. Initially diagnosed with medial epicondylitis, she was later diagnosed with subclavian thrombosis caused by Paget–Schröetter syndrome.ConclusionPresentations such as these are often attributable to soft-tissue injuries that resolve with rest and sometimes physiotherapy. Subclavian thrombosis was a highly unexpected diagnosis in this case; however, family physicians must remain vigilant in considering rare causes of common clinical presentations which could cause patients significant morbidity if left undiagnosed.
Highlights
Subclavian vein thrombosis is a rare but potentially fatal condition that most often occurs iatrogenically or in the context of malignancy
Subclavian thrombosis was a highly unexpected diagnosis in this case; family physicians must remain vigilant in considering rare causes of common clinical presentations which could cause patients significant morbidity if left undiagnosed
* Correspondence: mgkidd@ucalgary.ca 1Department of Family Medicine, Faculty of Medicine, University of Calgary, 3330 Hospital Drive NW, Calgary, Alberta T2N 4N1, Canada Full list of author information is available at the end of the article often occurs in the context of central venous catheters, surgery or malignancy but, as we describe here, can have primary causes such as anatomic anomalies and Paget–Schröetter syndrome [2]
Summary
MSK complaints comprise a large majority of presentations to the family physician, and most often they are soft-tissue injuries that resolve with rest and physiotherapy. Authors’ contributions MK saw the patient at her second presentation, made the diagnosis and initiated her treatment. She performed the literature review and analysis, and contributed to writing the manuscript. VB provided many aspects of the patient’s medical history, continues to see her in follow up and continues to coordinate her investigations. Both authors read and approved the final manuscript. Author details 1Department of Family Medicine, Faculty of Medicine, University of Calgary, 3330 Hospital Drive NW, Calgary, Alberta T2N 4N1, Canada. Author details 1Department of Family Medicine, Faculty of Medicine, University of Calgary, 3330 Hospital Drive NW, Calgary, Alberta T2N 4N1, Canada. 2Discipline of Family Medicine, Memorial University of Newfoundland, St John’s A1B 3V6, Canada
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